NPIMap

Community Nursing Service

Organization Active NPI Community Based Hospice Care Agency · St George, UT

NPI 1679701932 · NPPES record last updated Aug 17, 2018

Key facts

NPI
1679701932
Entity type
Organization (NPI type 2)
Primary specialty
Community Based Hospice Care Agency 251G00000X
License
2015-HOSPICE-93543 (UT)
Legal business name
COMMUNITY NURSING SERVICE
Practice address
720 S River Rd
Suite E 101
St George, UT 84790-5515
Phone
(435) 652-9077
Fax
(435) 652-9104
NPI assigned
Jun 25, 2009
Organization subpart
No

Authorized official

Name
Mr. Brent D Jones
Title
President & Ceo
Phone
(801) 233-6100

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Corporate family (same tax ID) 4

Organizations that report the same tax identification number in the National Provider Directory.

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

Medicare Care Compare: Hospice

Listed as
CNS Community Hospice - St George CCN 461584
Ownership
Other
Certified
Apr 14, 2011
Medicare certification status
Active (Provider of Services file)

Source: Medicare Care Compare.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in UT

Hospice certification: CCN 461584

Legal name
COMMUNITY NURSING SERVICE
Doing business as
CNS HOSPICE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Apr 14, 2011
Last certification
Nov 19, 2019
Ownership / control type
Non-Profit - Other
Organization structure
Corporation · Non-profit
Incorporated
Dec 29, 1994 in UT
Enrollment address
720S River Rd
E101
St George, UT 84790-5515

All disclosed owners & managing parties 10

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Gary M Kelso
Individual 		Corporate Director
Director		 Apr 1, 2020
Josette Dorius
Individual 		Corporate Director
Director		 Apr 28, 2009
Joseph Covey
Individual 		Corporate Director
Director		 Apr 1, 2020
David Gessel
Individual 		Corporate Director
Chairman of the Board		 Apr 1, 2020
Brent D Jones
Individual 		Corporate Officer
President		 Aug 17, 2009
W-2 Managing Employee
President		 Aug 17, 2009
Karrie Nielson
Individual 		W-2 Managing Employee
Area Manager		 Mar 9, 2009
Jaimi Ostergar
Individual 		Corporate Officer
Regional Vice President		 Jun 1, 2017 100%
Steven Leroy Love
Individual 		Corporate Officer
Senior VP		 Mar 22, 2008
W-2 Managing Employee
Senior VP		 Mar 22, 2008
Cherie Pratt Brunker
Individual 		Corporate Director
Director		 Apr 1, 2020
Michelle Zimbelman
Individual 		Contracted Managing Employee
Chief Financial Officer		 Aug 1, 2020

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20090924000301 UT Part a Provider - Hospice 9234036674 Practice locations: St George, UT

National Provider Directory

Tax ID family
Community Nursing Service (5 organizations share this tax ID)

Locations

720 S River Rd
Ste E101
St George, UT 84790
Phone (435) 652-9077

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X 2015-HOSPICE-93543 UT Yes

Addresses

Primary practice location

720 S River Rd
Suite E 101
St George, UT 84790-5515

Mailing address

2830 S Redwood Rd
Suite a
West Valley City, UT 84119-5625
Phone (801) 233-6100

Other names

  • CNS Community Hospice Doing business as

Other providers in St George, UT

All providers in St George, UT · Community Based Hospice Care Agency in Utah

Sources for this page

Verify at the official NPI Registry.